{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:38:34Z","timestamp":1782977914945,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Surgical treatment of fragility sacrum fractures with percutaneous sacroiliac (SI) screw fixation is associated with high failure rates. Turn\u2010out is detected in up to 20% of the patients. The aim of this study was to evaluate a new screw\u2010in\u2010screw implant prototype for fragility sacrum fracture fixation. Twenty\u2010seven artificial hemipelvises were assigned to three groups (<jats:italic>n<\/jats:italic>\u2009=\u20099) for instrumentation of an SI screw, the new screw\u2010in\u2010screw implant prototype, ora transsacral screw. Before implantation, a vertical osteotomy was set in zone 1 after Denis. All specimens were biomechanically tested to failure in upright position. Validated setup and test protocol were used for complex axial and torsional loading applied through the S1 vertebral body to promote turn\u2010out of the implants. Interfragmentary movements were captured via optical motion tracking. Screw motions were evaluated by means of triggered anteroposterior X\u2010rays. Interfragmentary movements and implant motions were significantly higher for SI screw fixation compared to both transsacral and screw\u2010in\u2010screw fixations. In addition, transsacral screw and screw\u2010in\u2010screw fixations revealed similar construct stability. Moreover, screw\u2010in\u2010screw fixation successfully prevented turn\u2010out of the implant that remained during testing at 0\u00b0 rotation for all specimens. From biomechanical perspective, fragility sacrum fracture fixation with the new screw\u2010in\u2010screw implant prototype provides higher stability than an SI screw, being able to successfully prevent turn\u2010out. Moreover, it combines the higher stability of transsacral screw fixation with the less risky operational procedure of SI screw fixation and can be considered as their alternative treatment option.<\/jats:p>","DOI":"10.1002\/jor.24895","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T14:23:47Z","timestamp":1603549427000},"page":"761-770","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Screw\u2010in\u2010screw fixation of fragility sacrum fractures provides high stability without loosening\u2014biomechanical evaluation of a new concept"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0484-887X","authenticated-orcid":false,"given":"Ivan","family":"Zderic","sequence":"first","affiliation":[{"name":"Biomechanical Department AO Research Institute Davos  Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4455-1018","authenticated-orcid":false,"given":"Daniel","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Schopper","sequence":"additional","affiliation":[{"name":"Biomechanical Department AO Research Institute Davos  Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Lodde","sequence":"additional","affiliation":[{"name":"Biomechanical Department AO Research Institute Davos  Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Richards","sequence":"additional","affiliation":[{"name":"Biomechanical Department AO Research Institute Davos  Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9795-115X","authenticated-orcid":false,"given":"Boyko","family":"Gueorguiev","sequence":"additional","affiliation":[{"name":"Biomechanical Department AO Research Institute Davos  Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pol","family":"Rommens","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3751-7639","authenticated-orcid":false,"given":"Yves P.","family":"Acklin","sequence":"additional","affiliation":[{"name":"Biomechanical Department AO Research Institute Davos  Davos Switzerland"},{"name":"Department of Orthopaedic and Trauma Surgery University Hospital Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00113-012-2335-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00003086-198802000-00010","article-title":"Sacral fractures: an important problem. Retrospective analysis of 236 cases","volume":"227","author":"Denis F","year":"1988","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1964.03060260029006"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-010-1108-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.08.038"},{"key":"e_1_2_7_7_1","first-page":"5","article-title":"Fragility fractures of the pelvis","author":"Rommens PM","year":"2017","journal-title":"JBJS reviews"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00113-007-1287-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2012.06.009"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1366605"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2013.06.023"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2471-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200307000-00001"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.00726"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-018-2938-5"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.11.002"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23401"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000739"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2012.03.003"},{"key":"e_1_2_7_20_1","first-page":"1230","article-title":"Locked plates reduce displacement of vertically unstable pelvic fractures in a mechanical testing model","volume":"69","author":"Humphrey CA","year":"2010","journal-title":"J Trauma"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(15)30031-0"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00064-006-1173-3"},{"key":"e_1_2_7_23_1","unstructured":"vdi\/vde.2002.Optical 3D measuring systems imaging systems with point\u2010by\u2010point probing. Beuth Verlag Verein Deutscher Ingenieure Berlin; pp.1\u201010."},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2017.03.023"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23554"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-019-03204-9"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200607000-00002"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23798"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200301000-00004"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2019.09.032"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B2.24567"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1243\/09544119JEIM347"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199304000-00002"},{"key":"e_1_2_7_34_1","first-page":"25","article-title":"Method for measuring the comparative stability of osteosynthesis in the dorsal pelvic ring","volume":"24","author":"Kraus E","year":"1998","journal-title":"Unfallchirurgie"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001063"},{"key":"e_1_2_7_36_1","doi-asserted-by":"crossref","unstructured":"LoddeMF KatthagenJC SchopperCO et al.2020. Biomechanical comparison of common fixation techniques for unstable fragility fractures of the pelvic ring. In preparation.","DOI":"10.3390\/jcm10112326"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.24895","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jor.24895","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.24895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T11:12:53Z","timestamp":1693566773000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.24895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,5]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/jor.24895"],"URL":"https:\/\/doi.org\/10.1002\/jor.24895","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,5]]},"assertion":[{"value":"2020-05-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}